Managing Managed Care

Our inequitable, inefficient, oftentimes uncaring health care "system," revealed. -- Jeffrey G. Kaplan, M.D., M.S.

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Ear Wax

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The use of a bulb syringe at home may help relieve earwax blockage more effectively than a professional ear irrigation procedure. 240 adults in the U.K. got either ear drops and a bulb syringe to use at home or ear drops and then irrigation by a clinic nurse. Patients were reassessed after 2 weeks, and those with persistent blockage had their ears irrigated professionally.

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Timely or Delayed Breast Cancer Decision-Making

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"[Is] it true that early detection/screening will save your life? The answer to this is complicated, in part, because not all cancers are the same. In general, it is likely that screening will detect slow growing tumors better than fast growing ones. My favorite analogy is of a building with a security guard that takes an hour to circle the building.

The Real Cost of Not Immunizing

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Measles is back and people will be getting ill, harmed or worse because someone is refusing immunizations. OTOH, routine childhood immunizations may reduce the risk of leukemia. [1]

The EHR—on the Road Where a Cottage Industry Lived

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Improving doctors' quality, effectiveness and cost-benefit requires meaningful communication at all levels and settings. To cure health care's ills, there's an obvious remedy that is difficult, but not impossible to implement—make cogent information* available at the point of contact with the patient, regardless of setting and within HIPAA constraints. 

Obesity in Kids

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Adolescent obesity is a growing problem that causes consternation for all and for which there are few if any durable treatments available.  Non-treatment, however, is no option. Obese children, like their adult counterparts can develop metabolic syndrome with all of its attendant complications-- cardiovascular problems resulting from years of high blood sugar and lipid levels and consequent, diabetes and/or hypertension [1]. Pediatric Metabolic Syndrome May Not Be a Stable Diagnosis

Patient-Centered Caring

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Achieving patient-centered care is difficult, but essential; since paternalism is out, the patient has a greater role to play. The editorial, "Patient-Centered Care; What Is the Best Measuring Stick?" by Drs.

Myth: Drink plenty of fluids

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Flu or Common Cold?  JB wites: "I am really feeling sick and my temp is 100o even with two ibuprofen. Can you call in a script for Z pack and some cough medicine with codeine?" On Jan 16, 2011, at 7:39 AM Response: It's only because I care that I won't treat you without a proper examination by a qualified health care practitioner any more than I do my wife or grandkids (unless I have to).  

Autism and Autistic Behavior

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Autism Spectrum Disorders (ASDs) Understanding diseases that affect development of the brain, e.g. autism and schizophrenia is challenging because of the complexity of such diseases and the difficulty of studying developmental processes in human tissues. First, Definitions: The following provides standardized criteria to help diagnose ASD; it is from the American Psychiatric Association's Diagnostic and Statistical Manual-IV, Text Revision (DSM-IV-TR).

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